Growth and respiratory status at 3 years of age after moderate preterm, late preterm and early term births: the Japan Environment and Children's Study.

Abstract

Objective: To assess the association between gestational age at birth and the risk of growth failure and respiratory symptoms at 3 years of age.

Design: Cohort study using the Japan Environment and Children's Study database.

Patients: A total of 86 158 singleton infants born without physical abnormalities at 32-41 weeks of gestation were enrolled between January 2011 and March 2014.

Main outcome measures: Growth failure (weight <10th percentile and height <10th percentile) and respiratory symptoms (asthma and wheezing) at 3 years of age.

Methods: Logistic regression analysis was used to evaluate the risk of growth failure and respiratory symptoms in the moderately preterm, late preterm and early term groups compared with the full-term group after adjusting for socioeconomic and perinatal factors. Multiple imputation was used to reduce the attrition bias related to missing data.

Results: The respective adjusted ORs (95% CI) of growth failure and respiratory symptoms for the moderate preterm, late preterm and early term groups compared with the full-term group were as follows: weight <10th percentile, 2.29 (1.48-3.54), 1.43 (1.24-1.71) and 1.20 (1.12-1.28); height <10th percentile, 2.34 (1.59-3.45), 1.42 (1.25-1.60) and 1.15 (1.09-1.22); asthma, 1.63 (1.06-2.50), 1.21 (1.04-1.41) and 1.16 (1.09-1.23); and wheezing, 1.39 (1.02-1.90), 1.37 (1.25-1.51) and 1.11 (1.06-1.17).

Conclusion: Moderate preterm, late preterm and early term births were associated with a higher risk of growth failure and respiratory symptoms at 3 years of age than full-term births, with an inverse dose-response pattern.